NPIMap

Individual provider Active NPI

Mary Therese Shepperson, RPH

  • Pharmacist
  • Powhatan, VA
National Provider Identifier
1902932387
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0201006905 Issued in VA
Practice address
2511 Anderson Hwy
Powhatan, VA 23139-7508
Phone
(804) 598-5028
Fax
(804) 598-6117
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0201006905 VA Primary
Pharmacist 183500000X 0202006905 VA

Addresses

Primary practice location

2511 Anderson Hwy
Powhatan, VA 23139-7508

Mailing address

3474 Richards Run
Powhatan, VA 23139-5800
Phone (804) 598-1699

Other practice location 1

1800 South Creek One Suite L
Powhatan, VA 23139
Phone (804) 379-6986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0201006905VAMDPharmacist
0202006905VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia CVS Pharmacy, L.L.C. PastSince Dec 6, 2020 Accepting new patients
Virginia CVS Pharmacy LLC PastSince Dec 6, 2020 Accepting new patients
Powhatan Pharmacy Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1902932387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3474 RICHARDS RUN",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231395800",
            "telephone_number": "804-598-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 ANDERSON HWY",
            "city": "POWHATAN",
            "state": "VA",
            "postal_code": "231397508",
            "telephone_number": "804-598-5028",
            "fax_number": "804-598-6117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 South Creek One Suite L",
            "address_purpose": "LOCATION",
            "city": "Powhatan",
            "state": "VA",
            "postal_code": "23139",
            "country_code": "US",
            "telephone_number": "804-379-6986",
            "fax_number": "804-379-1086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEPPERSON",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0201006905",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202006905",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powhatan, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.